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Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study

Introduction: Among its effect on virtually all other organs, COVID-19 affects the cardiovascular system, potentially jeopardizing the cardiovascular health of millions. Previous research has shown no indication of macrovascular dysfunction as reflected by carotid artery reactivity, but has shown su...

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Autores principales: Willems, Loes H., Jacobs, Lotte M. C., Groh, Laszlo A., ten Cate, Hugo, Spronk, Henri M. H., Wilson-Storey, Boden, Hannink, Gerjon, van Kuijk, Sander M. J., Ghossein-Doha, Chahinda, Nagy, Magdi, Thijssen, Dick H. J., van Petersen, André S., Warlé, Michiel C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965558/
https://www.ncbi.nlm.nih.gov/pubmed/36835948
http://dx.doi.org/10.3390/jcm12041413
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author Willems, Loes H.
Jacobs, Lotte M. C.
Groh, Laszlo A.
ten Cate, Hugo
Spronk, Henri M. H.
Wilson-Storey, Boden
Hannink, Gerjon
van Kuijk, Sander M. J.
Ghossein-Doha, Chahinda
Nagy, Magdi
Thijssen, Dick H. J.
van Petersen, André S.
Warlé, Michiel C.
author_facet Willems, Loes H.
Jacobs, Lotte M. C.
Groh, Laszlo A.
ten Cate, Hugo
Spronk, Henri M. H.
Wilson-Storey, Boden
Hannink, Gerjon
van Kuijk, Sander M. J.
Ghossein-Doha, Chahinda
Nagy, Magdi
Thijssen, Dick H. J.
van Petersen, André S.
Warlé, Michiel C.
author_sort Willems, Loes H.
collection PubMed
description Introduction: Among its effect on virtually all other organs, COVID-19 affects the cardiovascular system, potentially jeopardizing the cardiovascular health of millions. Previous research has shown no indication of macrovascular dysfunction as reflected by carotid artery reactivity, but has shown sustained microvascular dysfunction, systemic inflammation, and coagulation activation at 3 months after acute COVID-19. The long-term effects of COVID-19 on vascular function remain unknown. Materials and Methods: This cohort study involved 167 patients who participated in the COVAS trial. At 3 months and 18 months after acute COVID-19, macrovascular dysfunction was evaluated by measuring the carotid artery diameter in response to cold pressor testing. Additionally, plasma endothelin-1, von Willebrand factor, Interleukin(IL)-1ra, IL-6, IL-18, and coagulation factor complexes were measured using ELISA techniques. Results: The prevalence of macrovascular dysfunction did not differ between 3 months (14.5%) and 18 months (11.7%) after COVID-19 infection (p = 0.585). However, there was a significant decrease in absolute carotid artery diameter change, 3.5% ± 4.7 vs. 2.7% ± 2.5, p—0.001, respectively. Additionally, levels of vWF:Ag were persistently high in 80% of COVID-19 survivors, reflecting endothelial cell damage and possibly attenuated endothelial function. Furthermore, while levels of the inflammatory cytokines interleukin(IL)-1RA and IL-18 were normalized and evidence of contact pathway activation was no longer present, the concentrations of IL-6 and thrombin:antithrombin complexes were further increased at 18 months versus 3 months (2.5 pg/mL ± 2.6 vs. 4.0 pg/mL ± 4.6, p = 0.006 and 4.9 μg/L ± 4.4 vs. 18.2 μg/L ± 11.4, p < 0.001, respectively). Discussion: This study shows that 18 months after COVID-19 infection, the incidence of macrovascular dysfunction as defined by a constrictive response during carotid artery reactivity testing is not increased. Nonetheless, plasma biomarkers indicate sustained endothelial cell activation (vWF), systemic inflammation (IL-6), and extrinsic/common pathway coagulation activation (FVII:AT, TAT) 18 months after COVID-19 infection.
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spelling pubmed-99655582023-02-26 Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study Willems, Loes H. Jacobs, Lotte M. C. Groh, Laszlo A. ten Cate, Hugo Spronk, Henri M. H. Wilson-Storey, Boden Hannink, Gerjon van Kuijk, Sander M. J. Ghossein-Doha, Chahinda Nagy, Magdi Thijssen, Dick H. J. van Petersen, André S. Warlé, Michiel C. J Clin Med Article Introduction: Among its effect on virtually all other organs, COVID-19 affects the cardiovascular system, potentially jeopardizing the cardiovascular health of millions. Previous research has shown no indication of macrovascular dysfunction as reflected by carotid artery reactivity, but has shown sustained microvascular dysfunction, systemic inflammation, and coagulation activation at 3 months after acute COVID-19. The long-term effects of COVID-19 on vascular function remain unknown. Materials and Methods: This cohort study involved 167 patients who participated in the COVAS trial. At 3 months and 18 months after acute COVID-19, macrovascular dysfunction was evaluated by measuring the carotid artery diameter in response to cold pressor testing. Additionally, plasma endothelin-1, von Willebrand factor, Interleukin(IL)-1ra, IL-6, IL-18, and coagulation factor complexes were measured using ELISA techniques. Results: The prevalence of macrovascular dysfunction did not differ between 3 months (14.5%) and 18 months (11.7%) after COVID-19 infection (p = 0.585). However, there was a significant decrease in absolute carotid artery diameter change, 3.5% ± 4.7 vs. 2.7% ± 2.5, p—0.001, respectively. Additionally, levels of vWF:Ag were persistently high in 80% of COVID-19 survivors, reflecting endothelial cell damage and possibly attenuated endothelial function. Furthermore, while levels of the inflammatory cytokines interleukin(IL)-1RA and IL-18 were normalized and evidence of contact pathway activation was no longer present, the concentrations of IL-6 and thrombin:antithrombin complexes were further increased at 18 months versus 3 months (2.5 pg/mL ± 2.6 vs. 4.0 pg/mL ± 4.6, p = 0.006 and 4.9 μg/L ± 4.4 vs. 18.2 μg/L ± 11.4, p < 0.001, respectively). Discussion: This study shows that 18 months after COVID-19 infection, the incidence of macrovascular dysfunction as defined by a constrictive response during carotid artery reactivity testing is not increased. Nonetheless, plasma biomarkers indicate sustained endothelial cell activation (vWF), systemic inflammation (IL-6), and extrinsic/common pathway coagulation activation (FVII:AT, TAT) 18 months after COVID-19 infection. MDPI 2023-02-10 /pmc/articles/PMC9965558/ /pubmed/36835948 http://dx.doi.org/10.3390/jcm12041413 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Willems, Loes H.
Jacobs, Lotte M. C.
Groh, Laszlo A.
ten Cate, Hugo
Spronk, Henri M. H.
Wilson-Storey, Boden
Hannink, Gerjon
van Kuijk, Sander M. J.
Ghossein-Doha, Chahinda
Nagy, Magdi
Thijssen, Dick H. J.
van Petersen, André S.
Warlé, Michiel C.
Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study
title Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study
title_full Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study
title_fullStr Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study
title_full_unstemmed Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study
title_short Vascular Function, Systemic Inflammation, and Coagulation Activation 18 Months after COVID-19 Infection: An Observational Cohort Study
title_sort vascular function, systemic inflammation, and coagulation activation 18 months after covid-19 infection: an observational cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9965558/
https://www.ncbi.nlm.nih.gov/pubmed/36835948
http://dx.doi.org/10.3390/jcm12041413
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